tbuckley/cabot-search huggingface dataset:
A demographic and socioeconomic analysis of risk factors in meningeal melanomatosis.
Authors: Evan J Jacobs, Madison Cook, Xinxin Wu, Darby Keirns, Peter T. Silberstein, Beau Hsia
Journal: Journal of Clinical Oncology (2023)

e14019 Background: Meningeal melanomatosis (MM) is a rare and aggressive central nervous system neoplasm that normally occurs in the leptomeningeal melanocytes. Meningeal melanomatosis represents only 0.06% to 0.1% of all primary brain tumors, but it is accompanied with a very poor prognosis with data showing a mean survival of 10 weeks after diagnosis. Despite intrathecal chemotherapy treatment, only a modest positive effect on survival was observed. Limited research has been done. In this study, demographic factors in patients diagnosed with MM from the National Cancer Database (NCDB) were analyzed to elucidate potentially valuable insights regarding its epidemiology. Methods: A retrospective cohort study using data collected between 2004–2020 from the NCDB included 137 patients with a histologically confirmed diagnosis of MN. The descriptive analysis included an examination of demographic factors such as sex, age, race, Hispanic status, insurance coverage, type of medical facility, and Charleson-Deyo score. Primary site was also analyzed. Results: A total of 137 patients were identified with a diagnosis of MM between 2004 – 2020. The most common primary sites of MM were the meninges, not otherwise specified (NOS) (43.8%), spinal meninges (29.2%) and cerebral meninges (19.0%). In the dataset, 50.4% of diagnosed patients were male. The average age of diagnosis was 51.4 years (SD = 21.5, range = 0 – 90 years). The majority of the individuals (73.7%) had a Charlson-Deyo comorbidity score of 0. Most of the individuals diagnosed with MM were non-Hispanic (83.9%) and 87.6% of patients with diagnosed MM were White. Among the 115 patients with available data for median household income, 37.4% were in the top income quartile. A greater proportion of patients, 54.7%, had private insurance compared to those without insurance or those insured through Medicare or Medicaid. The majority of patients resided in metropolitan counties with a population exceeding 250,000 (71.8%) For patients with documented treatment facility type (N = 99), 56.6% of patients were treated in an academic/research program. Conclusions: This first NCDB analysis fills a crucial void in the existing knowledge on MM. MM affected males and females equally, contrary to published literature which suggested a slight predominance in males. The most common primary sites of diagnosis were the meninges NOS, spinal meninges and cerebral meninges, which supports findings in the literature. This is a novel description of the socioeconomic factors of MM patients in the literature, showing that these patients tend to have higher incomes and reside in densely populated metropolitan areas, and are more likely to receive treatment in an academic medical facility. Additional research is imperative to elucidate the influence of demographic and socioeconomic factors on the diagnosis, treatment options, and overall survival outcomes for patients with MM.
Impact of transfusion burden on health-related quality of life (HRQOL) and functioning in patients (pts) with myelofibrosis (MF): Post hoc analysis of SIMPLIFY-1 (S1) and -2 (S2).
Authors: Ruben A. Mesa, Francesca Palandri, Srdan Verstovsek, Lucia Masarova, Claire Harrison, Flora Mazerolle, Boris Gorsh, Manal M'Hari, Zhaohui Wang, Catherine Elizabeth Ellis, Samineh Deheshi, Jun Kawashima, Robyn Von Maltzahn, Antoine Regnault
Journal: Journal of Clinical Oncology (2023)

7066 Background: MF is associated with substantial symptom burden that can negatively impact pt quality of life (QOL). Transfusions may reduce anemia-associated symptoms, but can be burdensome and carry complications that may affect social, emotional, and general health; thus, QOL may be further negatively affected in transfusion-dependent (TD) pts. To characterize the relationship between transfusion burden and pt-reported outcomes (PROs), we report an exploratory post hoc analysis of the phase 3 S1 and S2 trials of the JAK1/JAK2/ACVR1 inhibitor momelotinib (MMB) in pts with MF. Methods: The pooled analysis set comprised both arms of the intent-to-treat populations of S1 (JAK inhibitor naive, MMB vs ruxolitinib [RUX]; N = 432) and S2 (JAK inhibitor exposed, MMB vs best available therapy [88% RUX]; N = 156). Transfusion independent (TI): no transfusions and hemoglobin (Hb) ≥8 g/dL in 12 wk; TD: ≥4 units transfused or Hb &lt; 8 g/dL in 8 wk; transfusion requiring (TR): not meeting TI or TD criteria. PRO assessment: SF-36v2 (physical functioning [PF], role-physical [RP], general health [GH], vitality [VT], social functioning [SF], and mental health [MH] domains; norm-based scores [NBS] range from 11.6 to 70.4 based on domain). PROs by transfusion status were described over the 24-wk randomized period. Results: SF-36v2 NBS were available from 503/588 pts in the pooled analysis set at baseline (BL); mean NBS in all domains were lower than the general population mean per the SF-36v2 Manual (50; SD, 10): PF, 39.6; RP, 39.0; GH, 39.8; VT, 43.6; SF, 43.2; MH, 46.3. Within the pooled analysis set, mean NBS in all domains at BL and week 24 (W24) were lower in TD vs TI pts. Among BL TD pts (n = 150) at W24, 75 remained TD (TD-TD), 40 became TI (TD-TI), 21 became TR, and 14 had no data. Pts who became TI experienced greater improvement (positive mean change from BL) in most domains vs pts who remained TD (Table). Conclusions: Among pts with MF in S1 and S2, TD pts had lower functioning and HRQOL than TI pts across SF-36v2 domains, suggesting that transfusion dependence has detrimental effects on multiple aspects of QOL. Among BL TD pts, those who became TI at W24 had greater improvement across most domains than those who remained TD, with mean changes for TD-TI pts near or above the minimally important difference (2 or 3, based on domain) for groups with low BL NBS. These analyses highlight transfusion dependence as a key pt-centered outcome and support further research into the impact of transfusions on QOL in MF. Clinical trial information: NCT01969838 ; NCT02101268 . [Table: see text]
Efficacy and safety of donafenib combined with transcatheter arterial chemoembolization (TACE) and anti-PD1 antibody for the treatment of unresectable hepatocellular carcinoma (uHCC): A retrospective study.
Authors: Naijian Ge, Xiangdong Wang
Journal: Journal of Clinical Oncology (2023)

e16120 Background: For unresectable hepatocellular carcinoma (uHCC), the efficacy of TACE monotherapy is not satisfactory. It has recently been reported that molecular targeted drugs combined with anti-PD1 antibody and TACE exhibit improved anti-tumor efficacy compared with monotherapy. Donafenib is a new generation of multi-kinase inhibitor which is approved as the first-line treatment for uHCC. This study aimed to explore the efficacy and safety of the combination therapy of donafenib, anti-PD1 monoclonal antibody and TACE in patients with uHCC. Methods: This was a single-center retrospective study, and involved patients with uHCC who received donafenib (200 mg po bid) combined with TACE and anti-PD1 monoclonal antibody or donafenib (200 mg po bid) combined with TACE at Shanghai Eastern Hepatobiliary Surgery Hospital from September 2021 to September 2022. All patients had at least one measurable lesion defined by mRECIST criteria. The objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS) data of patients were collected and analyzed. Results: A total of 34 patients with uHCC were included and had a median age of 56 years (32–81 years). Of these patients, 3 (9%) were classed as BCLC stage B, 31 (91%) were BCLC stage C. All 34 patients were complicated with HBV infection. First-line treatment was administered to 24 patients (71%), among which 21 patients received donafenib combined with TACE and anti-PD1 antibody. 3 patients were treated with donafenib combined with TACE. The remaining 10 patients (19%) received second-line treatment, among which 7 patients were treated with donafenib combined with TACE and anti-PD1 antibody. 3 patients received donafenib combined with TACE. There were 14 patients (41%) with baseline AFP ≥400 ng/mL. At data cut-off, the median follow-up time was 5 months [95% CI: 3.42-6.58]. The best overall response rate (BOR) was complete response in 5 patients (14.7%), partial response in 13 patients (38.2%), stable disease in 10 patients (29.4%), and progressive disease in 6 patients (17.6%). The ORR was 52.9% (95%CI: 36.7–68.6%) and DCR was 82.4% (95%CI: 66.5–91.7%). The median PFS and median OS were not reached, the one-year PFS rate was 61.6% (95%CI: 38–78.7%), and the one-year OS rate was 83.1% (95%CI: 56.1–95.2%). The ORR (58%) and DCR (87.5%) of patients receiving first-line treatment were better compared with those of patients receiving second-line treatment (40% and 70%, respectively). Treatment-related adverse events (TRAE) were reported by 30 patients (88.2%), of which 7 patients (20.6%) had grade 3 TRAE. No grade 4 or 5 TRAE was reported. Conclusions: Donafenib combined with TACE and anti-PD-1 antibody exhibited encouraging efficacy and favorable safety profile in patients with uHCC.
Evaluation of a novel Re-VASC score to differentiate malignant and benign T1a renal masses.
Authors: Cameron Fateri, Bradley Roth, Sriram Rao, Akhil Peta, Clifford Danza, Sailesh Wignarajah, Sung-Mee Park, Nina Kar, Roozbeh Houshyar, Jaime Landman
Journal: Journal of Clinical Oncology (2023)

e16548 Background: Early characterization of renal cell carcinoma (RCC) is pertinent for cancer prognosis and patient treatment. However, characterization of renal masses as benign or malignant on computed tomography (CT) remains a difficult clinical challenge. Angiogenesis plays a major role in RCC progression and assessing neovascularity in tumor-burdened kidneys with Re-VASC scoring has been shown to aptly predict tumor pathology and staging. In the current study, we evaluated if Re-VASC can reliably differentiate between malignant T1a ( &lt; 4cm) RCC and benign T1a renal masses. Methods: All eligible patients had a diagnosis of T1a from pathologic or clinical evaluation. The inclusion criteria for malignant masses included a diagnosis of RCC by pathology after partial or radical nephrectomy. Our T1a benign group was comprised of patients with a diagnosis of a non-malignant renal mass (angiomyolipoma or oncocytoma) established via histopathology or CT imaging (fat containing lesions). Re-VASC score was calculated on axial preoperative contrast enhanced CT utilizing the system described below: 0 = No visible neovascularization 1 = visualized single new vessel &lt; 3mm in diameter 2 = visualized single new vessel ≥3mm in diameter 3 = visualized multiple new vessels &lt; 3mm in diameter 4 = visualized multiple new vessels and at least one vessel ≥3mm in diameter. Results: A total of 64 benign and 69 malignant T1a tumors were included. Comparison of the two groups demonstrated no significant differences with regards to age, sex, ASA, and BMI. The average Re- VASC scores was 0.159 and 0.753 for benign and malignant masses respectively (p &lt; 0.001). Additionally, the tumor size for benign masses was 2.373 and for malignant masses was 2.546 (p = 0.210). There was no significant difference in Re-VASC score between the contralateral kidneys of malignant and benign kidney masses (p &lt; 0.508). Additionally, the sensitivity, specificity and positive predictive values were 26%, 86% and 74% respectively, when utilizing a Re-VASC score of 1 as a cutoff for malignancy. Conclusions: Our results show a significantly higher Re-VASC score in T1a malignant tumors and T1a benign tumors. While biopsy remains the gold standard for confirmation of malignant tumors such as RCC, radiological evaluation with tumor scoring systems like Re-VASC may offer a useful clinical decision-making tool in a less-invasive manner. Because renal biopsy carries non-negligible risk of complications, reducing volume of biopsies among low-risk patients may lead to better overall care. The Re-VASC score shows potential as a confirmatory test with a specificity of 86%. We would like to apply the Re-VASC score to an expanded multi-center trial, in order to assess its translatability to the general population.
Changing survival of intrahepatic cholangiocarcinoma based on Surveillance, Epidemiology, and End Results Database (2000–2018).
Authors: Yating Wang, Leo Edward Reap, Kevin Wei-Lun Chang, Howard R. Terebelo, Susan Elizabeth Lyons, Zhiyong Yu, Qian Yu
Journal: Journal of Clinical Oncology (2023)

e16182 Background: Intrahepatic cholangiocarcinoma (iCCA) is a primary hepatic malignancy arising from peripheral intrahepatic bile ducts with poor survival and increasing incidence. Treatment regimen has changed in the last two decades, whereas new molecular targeted therapies have emerged. The present study aims to characterize changes in treatment outcomes of iCCA using a national representative database. Methods: Data were retrieved from the Surveillance, Epidemiology and End Results (SEER) 18 Research Plus Database. Overall survival (OS) was analyzed based on age, gender, race, histological grade, stage, and treatment. Predictors of OS were evaluated by Cox regression models. Statistical analysis was performed with Stata 15.1 (STATA Corp., College Station, TX, USA). Results: The overall observed OS from 2000 to 2018 at 12, 36, and 60 months were 42.6%, 16.4%, and 10.2%, respectively. The median survival time (MST) increased from 6 to 11 months from 2000-2004 time period to 2015-2018 (p &lt; 0.0001). Such an improved trend was observed in all stage groups (p &lt; 0.0001). Among patients diagnosed after 2015, the 12, 24, and 36 month OS were 45.9%, 26.4% and 17.4 %, respectively; the MST were 25, 13, and 6 months for patients with localized (12-month OS: 72.7%; 36-month OS: 37.5% ), regional (12-month OS: 51.4%; 36-month OS: 18.9%), and distant diseases(12-month OS: 28.2%; 36-month OS: 4.5%), respectively (p &lt; 0.0001). On multivariable analysis, older age, female, grade, stage, whether surgery, chemotherapy or radiotherapy was performed were statistically significant predictors of OS (p &lt; 0.001). Conclusions: Survival outcomes of iCCA improved in the last twenty years in all cancer stages. Age, gender, grade, stage, and whether interventions were performed were prognostic factors.
Phase Ib neoadjuvant CG0070 and nivolumab (N) for cisplatin (C)-ineligible muscle invasive bladder cancer (MIBC).
Authors: Roger Li, Philippe E. Spiess, Wade J. Sexton, Michael Adam Poch, Logan Zemp, Julio M. Pow-Sang, Jingsong Zhang, Jasreman Dhillon, Gustavo Borjas, Shreyas U Naidu, Denise Dorman, James M. Burke, James J Mule, Jose Conejo-Garcia, Rohit K. Jain
Journal: Journal of Clinical Oncology (2023)

e16613 Background: CG0070 is a replication-competent oncolytic adenovirus engineered to target RB deficient tumor cells and to express GM-CSF. CG0070 has previously demonstrated safety and efficacy against BCG-exposed high risk non-muscle invasive bladder cancer through tumor lysis and anti-tumor immune activation. We tested the safety and efficacy of CG0070 in combination with N as neoadjuvant therapy for MIBC in C-ineligible patients in this study (NCT04610671). Methods: C-ineligible pts with MIBC (cT2-4a, N≤1) were enrolled. Pts received 6 weekly intravesical CG0070 (1x10 12 vp) and 2 doses of N at wks 2 and 6, followed by radical cystectomy (RC). The primary objective is safety of CG0070+N as measured by CTCAEv5.0. Secondary objective is to assess pathologic response (PaR) (pT0N0) and 1yr event free survival (EFS). Exploratory objectives include the assessment of correlation between PaR with baseline 1) E2F expression; 2) immune infiltration; 3) PD-L1 expression; and 4) TLS expression. Results: Between Nov 2020 and Feb 2023, 21 pts were enrolled with median age 75yrs, 81% male, 33% &gt; cT2; 1 pt refused RC but was included in the ITT population. Treatment was stopped after 1 infusion of CG0070 in 1 pt due to treatment unrelated worsening of renal function. The overall rate of &gt;grade 3 AEs was 12/20 (60%), and the vast majority were related to RC (83%). Immune related AEs were seen in 1 pt, who had grade 2 autoimmune thyroiditis. There was no delay in time to RC and no unexpected surgical complications from treatment. Overall, 1 pt was unevaluable for efficacy, 2 pts progressed prior to RC, PaR was observed in 8/15 (53%) evaluable pts, and an additional pt had negative post-treatment biopsy but refused RC. On exploratory analysis, treatment response correlated with increased maturation of tertiary lymphoid structures and immunogenicity to bespoke tumor neoantigens. Conclusions: Neoadjuvant CG0070+N is safe and effective in C-ineligible pts with MIBC. This combination was well tolerated without any delays in RC and induced an overall response rate of 50%. Clinical trial information: NCT04610671 .
UK cancer healthcare professionals collaborating with colleagues in low- and middle-income counties: Mapping the extent and nature of partnerships.
Authors: Kim Diprose, Philippa Lewis, Annie Young, Bhawna Sirohi, Neil Ranasinghe, Miriam Claire Mutebi, Bishal Gyawali, Mark Lodge, Richard Sullivan, Richard Cowan, Susannah Jane Stanway
Journal: Journal of Clinical Oncology (2023)

e18512 Background: Most cancer deaths occur in low- &amp; middle-income countries (LMICs). In 2020, the UK Global Cancer Network (UKGCN) formed to unite those interested in Global Oncology &amp; to strengthen collaborative work with colleagues in LMICs to reduce morbidity &amp; mortality from cancer. For the first time in the UK, the UKGCN undertook a mapping exercise, to document the number &amp; type of collaborations between the UK &amp; LMIC partners. Methods: A semi-structured survey was developed &amp; performed over 10 weeks from February 2021, to identify UK individuals &amp; institutions engaged in clinical practice, research &amp;/or education with LMIC partners, where the aim was to improve the care of people with/at risk of cancer. The survey was emailed to individuals in NHS hospitals, charities, universities, other organisations, UKGCN members &amp; to contacts identified by a literature search. Results: A total of 639 invitations were sent &amp; 88 responses received. Results demonstrate a range of collaborative efforts spanning many areas of cancer control:health promotion &amp; prevention, diagnosis &amp; treatment to survivorship &amp; palliative care. A wide range of countries were represented: Sub-Saharan Africa, South America, MENA region, China &amp; South-East Asia. Projects included education &amp; training (146), clinical practice (144) &amp; research (226; Table). Funding sources for projects included academic institutions, private sector, United Nations agencies, UK government, arms-length bodies &amp; international government. Conclusions: This mapping exercise has demonstrated considerable UK collaboration with colleagues in LMICs across the continuum, involving all 3 domains of education, practice, &amp; research. This mapping exercise will serve as a baseline on which to build a more accurate database to measure future work. It will enable the UK community to guide domestic strategy, increase efficiency, enable innovation &amp; accelerate collaborations. Information from the survey has been used as a catalyst to create new partnerships between colleagues working in similar geographical settings, encouraging bidirectional learning leading to mutual benefit. Next steps include using this data to support calls for increased funding in global cancer care, &amp; for institutional recognition of, &amp; investment in, Global Oncology as a discipline. The survey will be repeated using more comprehensive methods to increase accuracy with a view to maintaining an up-to-date database.[Table: see text]
Real world data about stupp platform in the treatment of glioblastoma in a single center of Colombia.
Authors: Erick Andres Cantor Rizo, Javier Segovia, Luis Eduardo Pino, Henry Vargas, Ivan Triana, John Alejandro Murillo Silva, Aylen Vanessa Ospina Serrano
Journal: Journal of Clinical Oncology (2023)

e14065 Background: Glioblastoma cancer is a disease with high mortality reported worldwide. However, in Colombia and Latin America there is a large gap in terms of the information available regarding the characteristics and survival of these patients. Methods: This is an observational, descriptive study of a cohort of patients with glioblastoma cancer who initiated medical treatment at Fundación Santa Fe de Bogotá, a high complexity hospital. We analyzed clinical characteristics, IDH mutation, histology, treatments, progression free survival (PFS), overall survival (OSm) and treatment related complications. We use Kaplan Meier as survival statistic. Results: Twenty patients were included during the 48 months. The average age was 62 years. 65% males, 35% female. IDH mutation detection was performed in 100% of patients, and IDH1 was positive in 20% of the population. Regarding the anatomy location occipital lobe 5%, temporal 20%, parietal 5%, frontal 35%, other locations 35%, ECOG 0-1 were the 100%. Time from start to stupp platform after surgery was 6.1 weeks. All patients received the surgical treatment scheme, later stupp platform followed by temozolamide. In the survival analysis, 15% of patients died during follow-up and 35% progressed to first line. The median overall survival (OSm) 19m, and Progression-free survival (PFS) 14m for the global population. Adjusting survival models for confounding variables, in males the OSm 19 and 15.6m in females. The PDF 15,6m males and 11.8m in females. The OSm in patients with IDH negative 20m, and in the group with IDH1 mutated the OSm has not been reached to 18m of follow-up. Conclusions: Our cohort of patients is similar to the literature reported worldwide, gender may be a predictor of risk. We have good survival times with the stupp platform, rapid access to treatment may be a factor in favor of our good outcomes.